1. 2010 UBO/UBU Conference Health Budgets & Financial Policy 1 Briefing: ICD-10-PCS II Actually Building A Few Codes Date: 23 March 2010 Time: 1610–1700

2. 2010 UBO/UBU Conference Turning Knowledge Into Action Objectives Actually try creating a few ICD-10-PCS codes 2

3. 2010 UBO/UBU Conference Turning Knowledge Into Action How the Class Will Work Quick review of the last class We’ll walk through the steps for one or two together In groups of three you will go through the steps We’ll go over the answers (most of the time there are multiple ICD-10-PCS for the most common MHS ICD-9- CM procedure codes) After we finish the most common MHS procedures, we will do some in each of the sections we have not used 3

4. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS How many characters in ALL PCS codes? What is the first character? – Body part – Body system – Approach – Section – Device – Qualifier – Root operation What comes first, the letters or the numbers? What is the character for medical and surgical section? 4

5. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS For removal of lesion from external right ear – what is the body system? For destruction of an endometrial implant of the abdominal wall – what is the body system? For resection of a carotid body – what is the body system? For excision of the glomus jugulare, or the coccygeal glomus, or the thyroid, or pituitary or pineal body – what is the body system? For excision of the stapes? 5

6. 2010 UBO/UBU Conference Turning Knowledge Into Action These Were the Most Common Principal Procedures in the MHS in FY09 We will walk through the first one together 6

7. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Circumcision – Section? – Body system? – Root operation – Body part? – Approach? – Any devices left after the healing is complete? – Is it diagnostic? 7

8. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Sections What section would a circumcision be in? 8

9. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Body Parts Note the 0 as the lead character – these are the Medical and Surgical Section body parts 9

10. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 10

11. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 11

12. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 12

13. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 13

14. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 14

15. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 15

16. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 16

17. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 17

18. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision, maybe resection 18

19. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision 19

20. 2010 UBO/UBU Conference Turning Knowledge Into Action ICD-10-PCS Root Operation Circumcision, the options are alteration, destruction, excision, resection 20

21. 2010 UBO/UBU Conference Turning Knowledge Into Action Circumcision Look it up in the alphabetic index: Circumcision – See Resection, Female Reproductive System 0UT – See Resection, Male Reproductive System 0VT Resection (page 104) – By Body System – Male Reproductive 0VT – By Body Part – (page 105, right column) prepuce 0VTT 21

22. 2010 UBO/UBU Conference Turning Knowledge Into Action Circumcision 0VTTXZZ Page 392 22

23. 2010 UBO/UBU Conference Turning Knowledge Into Action Your Turn – 75.69 Repair of Other Current Obstetric Laceration Section, body system, root operations, body part, approach, device, qualifier 23

24. 2010 UBO/UBU Conference Turning Knowledge Into Action 75.69 Repair of Other Current Obstetric Laceration To do this, you need to know the obstetric lacerations listed in ICD-9-CM procedures: 75.50 REPAIR OF CURRENT OBSTETRIC LACERATION OF UTERUS, NOT OTHERWISE SPECIFIED 75.51 REPAIR OF CURRENT OBSTETRIC LACERATION OF CERVIX 75.52 REPAIR OF CURRENT OBSTETRIC LACERATION OF CORPUS UTERI 75.61 REPAIR OF CURRENT OBSTETRIC LACERATION OF BLADDER AND URETHRA 75.62 REPAIR OF CURRENT OBSTETRIC LACERATION OF RECTUM AND SPHINCTER ANI 75.69 REPAIR OF OTHER CURRENT OBSTETRIC LACERATION 24

25. 2010 UBO/UBU Conference Turning Knowledge Into Action 75.69 Repair of Other Current Obstetric Laceration Alphabetic Index – what do you look under? Section – Medical and Surgical? Obstetrics? Body System – Skin? Subcutaneous? Female Reproductive? Root Operation – Repair? Body Part – Approach – Device – Qualifier – 25

26. 2010 UBO/UBU Conference Turning Knowledge Into Action 75.69 Repair of Other Current Obstetric Laceration 26

27. 2010 UBO/UBU Conference Turning Knowledge Into Action 75.69 Repair of Other Current Obstetric Laceration 0HQ9XZZ 27

28. 2010 UBO/UBU Conference Turning Knowledge Into Action 75.69 Repair of Other Current Obstetric Laceration 0JQB0ZZ 0JQB3ZZ 28

29. 2010 UBO/UBU Conference Turning Knowledge Into Action 74.1 Low Cervical Cesarean Section Alphabetic Index – what do you look under? Section – Medical and Surgical? Obstetrics? Body System – Female Reproductive? Pregnancy? Root Operation – Delivery? Body Part – Products of Conception? Approach – Open? Device – Qualifier – 0 Classical; 1 Low cervical; 2 Extraperitoneal 29

30. 2010 UBO/UBU Conference Turning Knowledge Into Action 10D00Z1 – Low Cervical Cesarean Section 30

31. 2010 UBO/UBU Conference Turning Knowledge Into Action 99.55 Prophylactic Administration of Vaccine Against Other Disease 99.31 VACCINATION AGAINST CHOLERA 99.32 VACCINATION AGAINST TYPHOID AND PARATYPHOID FEVER 99.33 VACCINATION AGAINST TUBERCULOSIS 99.34 VACCINATION AGAINST PLAGUE 99.35 VACCINATION AGAINST TULAREMIA 99.37 VACCINATION AGAINST PERTUSSIS 99.41 ADMINISTRATION OF POLIOMYELITIS VACCINE 99.42 VACCINATION AGAINST SMALLPOX 99.43 VACCINATION AGAINST YELLOW FEVER 99.44 VACCINATION AGAINST RABIES 99.45 VACCINATION AGAINST MEASLES 99.46 VACCINATION AGAINST MUMPS 99.47 VACCINATION AGAINST RUBELLA 31

32. 2010 UBO/UBU Conference Turning Knowledge Into Action 99.55 Prophylactic Administration of Vaccine Against Other Disease 99.48 ADMINISTRATION OF MEASLES-MUMPS-RUBELLA VACCINE 99.51 PROPHYLACTIC VACCINATION AGAINST THE COMMON COLD 99.52 PROPHYLACTIC VACCINATION AGAINST INFLUENZA 99.53 PROPHYLACTIC VACCINATION AGAINST ARTHROPOD-BORNE VIRAL ENCEPHALITIS 99.54 PROPHYLACTIC VACCINATION AGAINST OTHER ARTHROPOD- BORNE VIRAL DISEASES 99.55 PROPHYLACTIC ADMINISTRATION OF VACCINE AGAINST OTHER DISEASES 99.59 OTHER VACCINATION AND INOCULATION 32

33. 2010 UBO/UBU Conference Turning Knowledge Into Action 99.55 Prophylactic Administration of Vaccine Against Other Disease – Section? Administration – Body system? (look on pages 550 and 551) – Root operation? – Body part? – Approach? – Device? – Qualifier? 33

34. 2010 UBO/UBU Conference Turning Knowledge Into Action 99.55 Prophylactic Administration of Vaccine Against Other Disease 3E0134Z 34

35. 2010 UBO/UBU Conference Turning Knowledge Into Action 99.55 Prophylactic Administration of Vaccine Against Other Disease 3E0234Z 35

36. 2010 UBO/UBU Conference Turning Knowledge Into Action Practice On Your Own Answer list (based on General equivalency mappings) is at the front of the room 36

37. 2010 UBO/UBU Conference Turning Knowledge Into Action More Practice Answers at front of room 37

38. 2010 UBO/UBU Conference Turning Knowledge Into Action 38 Summary ONLY for inpatient procedures Does not include diagnosis Does not include laboratory Does not include sizes (e.g., of infants, lacerations) Each separate procedure has its own code Learn the root operations – then using the index is a breeze Starts 1 Oct 2013 Have fun

39. 2010 UBO/UBU Conference Turning Knowledge Into Action 39 Quiz Section for: – Termination of an ectopic pregnancy – Chemotherapy – Knee arthroscopy – Ultrasound – Removal of cerumen

40. 2010 UBO/UBU Conference Turning Knowledge Into Action 40 Quiz Answers Section for: – Termination of an ectopic pregnancy 10D28ZZ – Chemotherapy 3E06 – Knee arthroscopy 0 (inspection is root operation) – Ultrasound – trick – therapy is in 6, imaging is in B – Removal of cerumen – F Physical Rehabilitation and Diagnostic Audiology

41. 2010 UBO/UBU Conference Turning Knowledge Into Action Cerumen Management F09Z3XZ 41

42. 2010 UBO/UBU Conference Turning Knowledge Into Action 42 Q&A Questions?

43. 2010 UBO/UBU Conference Turning Knowledge Into Action Answers 43

44. 2010 UBO/UBU Conference Turning Knowledge Into Action Answers 44

45. 2010 UBO/UBU Conference Turning Knowledge Into Action 38.93 45

46. 2010 UBO/UBU Conference Turning Knowledge Into Action 81.54 46

47. 2010 UBO/UBU Conference Turning Knowledge Into Action 86.04 281 Options 47

48. 2010 UBO/UBU Conference Turning Knowledge Into Action 88.01 88.72 48

49. 2010 UBO/UBU Conference Turning Knowledge Into Action 86.22 87.03 49

50. 2010 UBO/UBU Conference Turning Knowledge Into Action 95.41 99.04 99.21 50

51. 2010 UBO/UBU Conference Turning Knowledge Into Action 73.4 75.69 51